Correlation Between Severe Covid-19 and Serum Troponin Regarding Significant Cardiac Disease

Background: Coronavirus disease 2019 (COVID-19) is a viral disease that affected multiple organs in the body. Identification of predictors for elevated serum troponin and significant cardiac disease involvement can help in managing the disease. Aims: to correlate between severe Covid-19 and S.troponin regarding significant cardiac disease. Patients and Methods: This was a cross-sectional study including 90 patients with SARS-CoV-2, Patients demographics and comorbidities were collected through direct interview. Laboratory parameter (C- reactive protein, D-Dimer) were obtained from patient 's record during days of admission, Laboratory parameter (serum Troponin I) which was ordered with daily routine investigations. Electrocardiography and Echocardiography were ordered when S.troponin is above (> 0.04 ng/ml). Echocardiography was done by a echocardiologist or a cardiologist at Al- Shiffa Hospital. Results: Serum Troponin Positive and Significant Cardiac disease in patients having a comorbidity in general was (15[21.74%] and 9[13.04%], respectively) compared with (2[18.88%] and 2 [18.22%], respectively) in patients with no comorbidity Although patients with comorbidity had higher percentage of cardiac disease than those without comorbidity, the difference statistically was not significant. In particular, patients with hypertension, DM, IHD and HF as comorbidity, had more Positive Serum Troponin and more Significant Cardiac disease (15[30.61%] and 9[18.37%],13[36.11%] and 8[22.22%], 12[26%] and 6[50%],6[75%] and 4[50%], respectively) than those without these comorbidities, the difference statistically was significant. Positive serum troponin had a positive significant correlation with each of serum CRP (r=0.35, p= 0.002), D-dimer (r=0.22, p= 0.048) and age (r= 0.31, p= 0.006) Although patients with elevated, D-dimer and older age had higher percentage of cardiac disease, the difference statistically was not significant. Conclusions: Older age patients and those with comorbidities, especially DM, IHD, HF and hypertension, are more prone for positive serum troponin and greater risk for significant cardiac disease in COVID-19. Inflammatory markers, in particular, CRP and D-dimer are significantly correlate with positive serum troponin and greater risk for significant cardiac disease. NSTEMI is more frequent than other cardiac diseases.